Working Partners for an

Alcohol- and Drug-Free Workplace

US Department of Labor

Employee Education Outline

• Objectives of training
• Overview of Drug-Free Workplace Policy
• Impact of substance abuse in the workplace
• Ways that people use alcohol and other drugs
• Understanding addiction
• Signs and symptoms of substance abuse
• Family and coworker impact
• Assistance
• Confidentiality
• Specific drugs of abuse

Objectives of Training

At the end of the training, employees should be familiar with the Drug-Free Workplace
Policy and aware of the dangers of alcohol and drug abuse.

Employees should understand:

• The requirements of the Drug-Free Workplace Policy.

• The prevalence of alcohol and drug abuse and its impact on the workplace
• How to recognize the link between poor performance and/or alcohol and drug abuse
• The progression of the disease of addiction
• What types of assistance may be available
Slides 1-3
Handout 1
 Working Partners for an
Alcohol- and Drug-Free Workplace
US Department of Labor

Overview of Drug-Free Workplace Policy

The Drug-Free Workplace Policy accomplishes two major things:

• Sends a clear message that use of alcohol and drugs in the workplace is prohibited.
• Encourages employees who have problems with alcohol and other drugs to
voluntarily seek help

The policy exists to:

• Protect the health and safety of all employees, customers and the public
• Safeguard employer assets from theft and destruction
• Protect trade secrets
• Maintain product quality and company integrity and reputation
• Comply with the Drug-Free Workplace Act of 1988 or any other applicable federal,
state or local laws

The Drug-Free Workplace Policy answers the following questions:

• What is the purpose of the policy and program?

• Who is covered by the policy?
• When does the policy apply?
• What behavior is prohibited?
• Are employees required to notify supervisors of drug-related convictions?
• Does the policy include searches?
• Does the program include drug testing?
• What are the consequences for violating the policy?
• Are there Return-to-Work Agreements?
• What type of assistance is available to employees needing help?
• How is employee confidentiality protected?
• Who is responsible for enforcing the policy?
• How is the policy communicated to employees?
Slides 4-7
Handout 2
 Working Partners for an
Alcohol- and Drug-Free Workplace
US Department of Labor

Impact of Substance Abuse in the Workplace

Employee Health – People who abuse alcohol or other drugs tend to neglect nutrition,
sleep and other basic health needs. Substance abuse depresses the immune system.

Impact on the workplace:

• Higher use of health benefits

• Increased use of sick time
• Higher absenteeism and tardiness

Productivity – Employees who are substance abusers can be physically and mentally
impaired while on the job. Substance abuse interferes with job satisfaction and the
motivation to do a good job.

Impact on the workplace:

• Reduced output
• Increased errors
• Lower quality of work
• Reduced customer satisfaction

Decision Making – Individuals who abuse alcohol and/or other drugs often make poor
decisions and have a distorted perception of their ability.

Impact on the workplace:

• Reduced innovation
• Reduced creativity
• Less competitiveness
• Poor decisions, both daily and strategic

Slide 8
Handout 3
 Working Partners for an
Alcohol- and Drug-Free Workplace
US Department of Labor

Safety – Common effects of substance abuse include impaired vision, hearing and muscle
coordination and low levels of attention, alertness and mental acuity.

Impact on the workplace:

• Increased accidents
• More workers’ compensation claims

Employee Morale – The presence of an employee with drug and/or alcohol problems
creates a strain on relationships between coworkers. Organizations that appear to
condone substance abuse create the impression that they don’t care.

Impact on the workplace:

• Higher turnover
• Lower quality
• Reduced team effort

Security – Employees with drug and/or alcohol problems often have financial
difficulties, and employees who use illegal drugs may be engaging in illegal activities in
the workplace.

Impact on the workplace:

• Theft
• Law enforcement involvement

Organizational Image and Community Relations – Accidents, lawsuits and other

incidents stemming from employee substance abuse problems may receive media
attention and hurt an organization’s reputation in the community.

Impact on the workplace:

• Reduced trust and confidence

• Reduced ability to attract high-quality employees
Slide 9
Handout 4
 Working Partners for an
Alcohol- and Drug-Free Workplace
US Department of Labor

Ways that People Use Alcohol and Other Drugs

Use: Alcohol and other drugs may be used in a socially accepted or medically authorized
manner to modify or control mood or state of mind. Examples include having a drink
with friends or taking an anti-anxiety agency as prescribed by a physician. Described
below are different ways that people use alcohol and other drugs without necessarily
becoming addicted.

Experimentation – Out of curiosity and/or at the urging of peers, individuals

may try drinking or using drugs illegally. If the illegal drug use is not repeated, or
discontinues after a short time, such experimentation may not be problematic.
Likewise, deciding to drink alcoholic beverages after early experimentation is not
problematic for most adults.

Social/Recreational – Drinking alcoholic beverages is permitted in American

society, and some excessive use may even be condoned. If use doesn’t cause
problems for the user, or those around him/her, most people would consider such
use to be social or recreational. Some use marijuana in a similar manner – only in
certain social or recreational situations and without immediate adverse
consequences. However, marijuana use is illegal, except in a few states.

As a Stress Reliever – Many people use alcohol or other drugs to help them cope
with pressure or stress. If this type of use is infrequent and doesn’t create more
stress or difficulties for the user, or those around him/her, it may not lead to
addiction, but alcoholism and drug addiction often begin with relief drinking.

Abuse: The use of a substance to modify or control mood or state of mind in a manner
that is illegal or harmful to oneself or others is considered problematic use, or abuse.
Examples of potential consequences of harmful use are:

• Accidents or injuries
• Blackouts
• Legal problems
• Poor job performance
• Family problems
• Sexual behavior that increases the risk of HIV infection

Addiction: A number of individuals occasionally use or abuse alcohol or drugs without

becoming addicted, but for many abuse continues despite repeated attempts to return to
more social or controlled use and leads to addiction. Addiction is the irresistible
compulsion to use alcohol and drugs despite adverse consequences. It is characterized by
repeated failures to control use, increased tolerance and increased disruption in the
family.
Slides 10-12
Handout 5
 Working Partners for an
Alcohol- and Drug-Free Workplace
US Department of Labor

Understanding Addiction

Unfortunately, it is not possible to tell early on whose use may lead to abuse and/or
addiction. For one in ten people, abuse leads to addiction.

Addiction to alcohol and other drugs is:

Chronic – Once you have developed an addiction, you will always have to deal with it.
You may manage to stop using alcohol or other drugs for significant periods of time, but
for most the disease doesn’t disappear but rather goes into remission. Should you attempt
to resume ‘normal’ use, you will rapidly return to addictive, out of control use and abuse.

Progressive – Addiction gets worse over time. With some drugs, the decline is rapid;
with others, like alcohol, it can be more gradual, but it does get worse. Alcohol and other
drugs cause a biochemical change in the nervous system that can persist even after the
substance leaves the blood. Repeated use causes progressive damage.

Primary – Addiction is not just a symptom of some underlying psychological problem, a

developmental stage or a reaction to stress. Once your use of alcohol or drugs has
become an addiction, the addiction itself needs to be medically treated as a primary
illness.

Terminal – Addiction to alcohol and/or other drugs often leads to disease and possibly
death.

Characterized by Denial – One of the most disturbing and confusing aspects of

addiction is that it is characterized by denial. The user denies that his/her use is out of
control or that it is causing any problems at home or work. The user often seems to be
the last to know that his/her life is out of control. There are effective strategies employed
by professionals for helping to break through this denial, which must be overcome before
treatment can take place.
Slide 13
Handout 6
 Working Partners for an
Alcohol- and Drug-Free Workplace
US Department of Labor

Risk of Addiction:

Addiction is a family disease:

Some people with a history of substance abuse in their family are more susceptible to
developing problems with addiction. Children of alcoholics or addicts are three times as
likely to develop problems. If both parents are addicts or alcoholics, the risk increases to
five times as great. This is due to heredity as well as learned behavior. It is important for
parents to realize that children learn much more from watching their behavior than
listening to their advice.

Prior abuse of alcohol and other drugs has a great impact on developing future
problems:

A pattern of abuse develops and can lead to addiction and psychological reliance on drugs
and/or alcohol. This can be a slow progression for some and a rapid decline for others.
Research demonstrates that the later in life an individual first drinks alcohol or uses other
drugs, the less likely he or she will be to progress to problem use.

Other contributing factors:

Some people abuse alcohol and drugs as part of a self-destructive lifestyle. Other people
start to use substances to seek relief from depression or crisis in their lives. Although
some fortunate individuals never develop serious problems and use diminishes or ceases
once the precipitating events change, others develop a serious problem before they even
realize it.
Slide 14
Handout 7
 Working Partners for an
Alcohol- and Drug-Free Workplace
US Department of Labor

Signs and Symptoms of Substance Abuse

Abuse of alcohol and other drugs affects people emotionally, behaviorally and physically.

Emotional Effects:

• Aggression
• Burnout
• Anxiety
• Depression
• Paranoia
• Denial

Behavioral Effects:

• Slow reaction time

• Impaired coordination
• Slowed or slurred speech
• Irritability
• Excessive talking
• Inability to sit still
• Limited attention span
• Poor motivation and lack of energy

Physical Effects:

• Weight loss
• Sweating
• Chills
• Smell of alcohol

Slides 15-18
Handout 8
 Working Partners for an
Alcohol- and Drug-Free Workplace
US Department of Labor

Family and Coworker Impact

Enabling: Action that someone takes to protect the person with the problem from the
consequences of his or her actions. Unfortunately, enabling actually helps the person to
NOT deal with his or her problem.

Examples of enabling include:

Covering Up – Providing alibis, making excuses or even doing an impaired worker’s

work rather than confronting the issue that he/she is not meeting his/her expectations.

Rationalizing – Developing reasons why the person’s continued substance abuse or

behavior is understandable or acceptable.

Withdrawing/Avoiding – Avoiding contact with the person with the problem.

Blaming – Blaming yourself for the person’s continued substance abuse or getting angry
at the individual for not trying hard enough to control his/her use or to get help.

Controlling – Trying to take responsibility for the person by throwing out his/her drugs,
cutting off the supply or trying to minimize the impact by moving him/her to a less
important job.

Threatening – Saying that you will take action (ceasing to cover up, taking formal
disciplinary action) if the employee doesn’t control his/her use, but not following
through.
Slides 19-20
Handout 9
 Working Partners for an
Alcohol- and Drug-Free Workplace
US Department of Labor

Examples of traps that family members and coworkers may fall into:

Sympathy – Trying to get you involved in his/her personal problems.

Excuses – Having increasingly improbable explanations for everything that happens.

Apology – Being very sorry and promising to change. (“It won’t happen again.”)

Diversions – Trying to get you to talk about other issues in life or in the workplace.

Innocence – Claiming he/she is not the cause of the problems you observe, but rather the
victim. (“It isn’t true.” “I didn’t know.” “Everyone is against me.”)

Anger – Showing physically intimidating behavior, blaming others. (“It’s your fault.”)

Pity – Using emotional blackmail to elicit your sympathy and guilt. (“You know what
I’m going through. How can you do this to me now?”)

Tears – Falling apart and expressing remorse upon confrontation.

Slide 21
Handout 10
 Working Partners for an
Alcohol- and Drug-Free Workplace
US Department of Labor

Assistance

Things to remember:

• Difficulty performing on the job can sometimes be caused by unrecognized personal

problems – including addiction to alcohol and other drugs
• Help is available
• Although a supervisor may suspect that an employee’s performance is poor because
of underlying personal problems, it is up to employee to decide whether or not that is
the case
• It is an employee’s responsibility to decide whether or not to seek help
• Addiction is treatable and reversible
• An employee’s decision to seek help is a private one and will not be made public

If EAP services are available:

• An EAP can help employees decide what to do if they have a problem with alcohol or
other drugs
• An EAP also can help an employee decide what to do if someone in his/her family or
workgroup has a problem
• Conversations with an EAP are confidential

If EAP services are not available, help may be available from:

• Community hotlines
• Self-help groups such as Alcoholics Anonymous, Narcotics Anonymous, Al-Anon,
etc.
• Community mental health centers
• Private therapists or counselors
• Addiction treatment centers

Slides 22-25
Handout 11
 Working Partners for an
Alcohol- and Drug-Free Workplace
US Department of Labor

Confidentiality

Employees need to know that:

• Problems will not be made public

• Conversations with an EAP professional – or other referral agent – are private and
will be protected
• All information related to performance issues will be maintained in his/her personnel
file
• Information about any referral to treatment, however, will be kept separately
• Information about treatment for addiction or mental illness is not a matter of public
record and cannot be shared without a release signed by the employee
• If an employee chooses to tell coworkers about his/her private concerns, that is
his/her decision
• When an employee tells his/her supervisor something in confidence, supervisors are
obligated to protect that disclosure

If EAP services are available, employees are also assured that:

• EAP records are separate from personnel records and can be accessed only with a
signed release from the employee
• EAP professionals are bound by a code of ethics to protect the confidentiality of the
employees and family members that they serve
• There are clear limits on when and what information an EAP professional can share
and with whom

However, there are some limits on confidentiality that may require:

• Disclosure of child abuse, elder abuse and serious threats of homicide or suicide as
dictated by state law
• Reporting participation in an EAP to the referring supervisor
• Reporting the results of assessment and evaluation following a positive drug test
• Verifying medical information to authorize release time or satisfy fitness-for-duty
concerns as specified in company policy
• Revealing medical information to the insurance company in order to qualify for
coverage under a benefits plan

Slides 26-29
Handout 12
 Working Partners for an
Alcohol- and Drug-Free Workplace
US Department of Labor

Specific Drugs of Abuse

Alcohol

In American society alcohol is a legal drug. Nonetheless, it is a depressant and is the

leading drug of abuse. Use of alcohol affects judgment and decision-making abilities,
slows down the central nervous system and brain function, and reduces coordination and
reflex actions.

Signs and symptoms of abuse:

• Dulled mental processes

• Lack of coordination
• Slowed reaction time
• Poor judgement
• Reduced inhibitions

Health effects:

• Decreased sexual functioning

• Liver disease
• Increased cancers of the mouth, tongue, pharynx, esophagus, rectum, breast and skin
• Kidney disease
• Ulcers
• Spontaneous abortion
• Birth defects – leading cause of preventable retardation

Workplace issues:

• Many employers now test for the presence of alcohol along with other drug testing.
• Consuming alcohol increases the likelihood that a driver or equipment operator will
be involved in an accident.
• Low doses of alcohol reduce inhibitions and affect decision making.
• People who would not ordinarily behave in inappropriate ways can be persuaded to
change their behavior when they are drinking.
• Often employees are under the influence of alcohol when they make the decision to
use drugs.
Slide 30
Handout 13
 Working Partners for an
Alcohol- and Drug-Free Workplace
US Department of Labor

Marijuana

Marijuana is a derivative of the hemp plant and is illegally used for its intoxicating effects
and dreamy state of relaxation and euphoria. All forms of marijuana have negative
physical and mental effects. The active ingredient in marijuana is Delta-9-
Tetrahydrocannabinol, or THC, and is present in all forms of the drug.

Signs and symptoms of use:

Physical
• Substantial increase in heart rate
• Bloodshot eyes
• Dry mouth and throat
• Increased appetite
• Chronic sore throat

Mental
• Impaired or reduced short-term memory and comprehension
• Altered sense of time
• Changed sensory perception--sight, smell, hearing, touch
• Reduced ability to perform tasks requiring concentration and coordination, such as
driving a car

Health effects:

• Emphysema-like symptoms
• Respiratory track and sinus infections
• Lowered immune system response

Workplace issues:

• Employees who fall under Federal guidelines such as the Department of

Transportation’s testing regulations are prohibited from using marijuana in any form.
• THC is stored in the body fat and is slowly released over time. Since it is retained in
the fat, an employee can test positive many days after use.
• Many employers also have work rules requiring the employee to disclose if he or she
is taking any sedating medications that could impact his or her ability to work safely.
This rule would apply even in states that have approved the medicinal use of
marijuana.
• The use of marijuana definitely would cause fitness-for-duty concerns.
Slide 30
Handout 14
 Working Partners for an
Alcohol- and Drug-Free Workplace
US Department of Labor

Inhalants

Inhalants are mood-altering substances that are voluntarily inhaled. Most substances used
are commercial and household products, such as solvents and aerosols, which are easily
obtained and not harmful, if used for the purpose intended and as directed. Because they
are common products, inhalants often are a young person’s first attempt at “getting high.”

Signs and symptoms of abuse:

Inhaling solvents allows the substance to reach the bloodstream very quickly. Immediate
negative effects of include:

• Nausea
• Sneezing
• Coughing
• Nosebleeds
• Fatigue
• Poor coordination
• Loss of appetite

Health effects:

• Hepatitis
• Brain damage
• Debilitating effects on the central nervous system
• Weight loss
• Fatigue
• Electrolyte imbalance
• Muscle fatigue
• Permanent damage to the nervous system

Workplace issues:

• Inhalants can severely impair judgment and driving ability.

• They also cause severe disorientation, visual distortion and confusion.
• Some such products may be available in the workplace.
Slide 30
Handout 15
 Working Partners for an
Alcohol- and Drug-Free Workplace
US Department of Labor

Cocaine

Cocaine is the most potent stimulant of organic origin and the most widely used of the
stimulants. Although cocaine has been used in the past as a topical anesthetic, its
therapeutic uses have almost been eliminated due to the development of safer anesthetics.
Cocaine is a powerfully addictive drug leading to physical and psychological
dependence.

Signs and symptoms of abuse:

• Dilated pupils
• Increased pulse rate
• Elevated blood pressure
• Insomnia
• Loss of appetite
• Tactile hallucinations
• Paranoia
• Seizures
• Anxiety, agitation
• Periods of increased activity followed by fatigue and depression
• Wide mood swings
• Difficulty in concentration

Health effects:

• Cocaine stimulates the central nervous system. Its immediate effects include dilated
pupils and elevated blood pressure, heart rate, respiratory rate and body temperature.
Cocaine use can lead to death by cardiac arrest or respiratory failure.

• Cocaine powder is sniffed or snorted. The euphoric high lasts for approximately 30
minutes. Occasional use can cause a stuffy or runny nose, while chronic use can
ulcerate the mucous membrane of the nose. Cocaine powder can also be injected into
the bloodstream when it is mixed with water. Using contaminated equipment to inject
cocaine, or any other substance, can transmit HIV and cause HIV/AIDS, hepatitis and
other infection diseases.

• Preparation of freebase, which involves the use of volatile solvents, can result in
death or injury from fire or explosion. Inhalation of cocaine fumes from freebasing
produces effects that are very fast in onset, very intense and momentary in duration.
Slide 30
Handout 16
 Working Partners for an
Alcohol- and Drug-Free Workplace
US Department of Labor

• Crack is cocaine that is processed into tiny chips having the appearance of slivers of
soap. Crack has become a very popular form of cocaine, since it is inexpensive and
relatively easy to use. It is smoked in a pipe or rolled with tobacco in a cigarette.
Cocaine can produce psychological and physical dependency, a feeling that the user
cannot function without the drug. Many users become extremely depressed when not
using the drug, and the craving for the drug is intense. In addition, tolerance develops
rapidly.

Workplace issues:

• Employees who fall under Federal guidelines such as the Department of

Transportation’s testing regulations are prohibited from using cocaine in any form.

• The addictive nature and cost can lead to workplace theft and/or dealing.

• Work performance is erratic with periods of high performance and periods

characterized by forgetfulness, absenteeism and missed assignments.
Slide 30
Handout 17
 Working Partners for an
Alcohol- and Drug-Free Workplace
US Department of Labor

Stimulants

Stimulants are drugs that stimulate the central nervous system and excite bodily activity.
Methamphetamine or crank is one of the fastest growing drugs of abuse. These drugs
create less intense and less expensive cocaine-like effects in the body.

Signs and symptoms of abuse:

• Mood changes
• Impaired concentration
• Impaired mental functioning
• Swings between apathy and alertness

Health effects:

• Increased heart and respiratory rates

• Elevated blood pressure
• Sweating
• Headaches
• Blurred vision
• Dizziness
• Sleeplessness and anxiety
• Rapid or irregular heartbeat
• Tremors
• Poor coordination
• Physical collapse

Workplace issues:

• Employees who fall under Federal guidelines such as the Department of

Transportation’s testing regulations are prohibited from using amphetamines without
a current prescription.

• The addictive nature and cost can lead to workplace theft and/or dealing.

• Work performance is erratic with periods of high performance and periods

characterized by forgetfulness, absenteeism and missed assignments.
Slide 30
Handout 18
 Working Partners for an
Alcohol- and Drug-Free Workplace
US Department of Labor

Depressants

A depressant is a drug that depresses the central nervous system, resulting in sedation and
a decrease in bodily activity. Depressants, taken as prescribed by physicians, can be
beneficial for the relief of anxiety, irritability, stress and tension.

Signs and symptoms of use:

• Slurred speech
• Staggered walk
• Altered perception
• Respiratory depression
• Coma and death

Health effects:

• The use of depressants can cause both physical and psychological dependence.
Regular use over time may result in a tolerance to the drug, leading the user to
increase the quantity consumed.

• The main classes of medical depressants are barbiturates and benzodiazepines. When
regular users suddenly stop taking large doses, they can develop withdrawal
symptoms ranging from restlessness, insomnia and anxiety to convulsions and death.

• Babies born to mothers who abuse depressants during pregnancy may be physically
dependent on the drugs and show withdrawal symptoms shortly after they are born.
Birth defects and behavioral problems also may result.

Workplace issues:

• Mental clouding and drowsiness pose a fitness-for-duty concern.

• Many employers also have work rules requiring the employee to disclose if they are
taking any sedating medications that could impact their ability to work safely.
Slide 30
Handout 19
 Working Partners for an
Alcohol- and Drug-Free Workplace
US Department of Labor

Hallucinogens

Hallucinogenic drugs distort the senses and often produce hallucinations--experiences

that depart from reality. Phencyclidine (PCP) interrupts the function of the neurocortex,
the section of the brain that controls the intellect and keeps instincts in check, because the
drug blocks pain receptors. Violent PCP episodes may result in self-inflicted injuries.

Signs and symptoms of use:

• Impaired concentration
• Confusion and agitation
• Muscle rigidity
• Profuse sweating

Health effects:

• Chronic users of PCP report persistent memory problems and speech difficulties.
• Some of these effects may last six months to a year following prolonged daily use.
• Mood disorders, such as depression, anxiety and violent behavior, also occur.
• In later stages of chronic use, users often exhibit paranoid and violent behavior and
experience hallucinations.
• Large doses may produce convulsions and coma, as well as heart and lung failure.

Workplace issues:

• Employees who fall under Federal guidelines such as the Department of

Transportation’s testing regulations are prohibited from using PCP.
• Use causes severe disorientation.
Slide 30
Handout 20
 Working Partners for an
Alcohol- and Drug-Free Workplace
US Department of Labor

Narcotics

Narcotic analgesics are the most effective compounds used for pain relief. Narcotic
analgesics include Opium, Opiates (morphine, codeine, percodan, heroin and dilaudid)
and Opioids (synthetic substitutes such as vicodin, darvon, demerol and methadone).

Signs and symptoms of use:

Narcotics initially produce a feeling of euphoria that is often followed by:

• Drowsiness
• Nausea and vomiting
• Constricted pupils
• Watery eyes and itching
• Low and shallow breathing
• Clammy skin
• Impaired respiration
• Convulsions
• Coma
• Possible death

Health effects:

• Tolerance to narcotics develops rapidly and addiction is likely.

• The use of contaminated syringes may result in diseases such as HIV/AIDS,
endocarditis and hepatitis.
• Addiction in pregnant women can lead to premature, stillborn or addicted infants who
experience severe withdrawal symptoms.

Workplace issues:

• Employees who fall under Federal guidelines such as the Department of

Transportation’s testing regulations are prohibited from using opiates without a
current medical prescription.
• Many employers also have work rules requiring the employee to disclose if they are
taking any sedating medications that could impact their ability to work safely.
• The addictive nature and cost can lead to workplace theft and/or dealing.
• Mental clouding and drowsiness pose a fitness-for-duty concern.

Slide 30
Handout 21
 Working Partners for an
Alcohol- and Drug-Free Workplace
US Department of Labor

Designer Drugs

Illegal drugs are defined in terms of their chemical formulas, but underground chemists
can modify the molecular structure of certain illegal drugs to produce analogs known as
designer drugs, which do not meet these definitions. These drugs can be several hundred
times stronger than the drugs they are designed to imitate.

Many of the so-called designer drugs are related to amphetamines and have mild
stimulant properties but are mostly euphoriants. They can produce severe neurochemical
damage to the brain. The narcotic analogs can cause symptoms such as those seen in
Parkinson’s disease, including uncontrollable tremors, drooling, impaired speech,
paralysis and irreversible brain damage. Analogs of amphetamines and
methamphetamines cause nausea, blurred vision, chills or sweating and faintness.

Psychological effects include anxiety, depression and paranoia. As little as one dose can
cause brain damage, and the designer drugs still cause illusions, hallucinations and
impaired perception.

Some designer drugs are: Synthetic Heroin White, MPTP (New Heroin), analogs of
MDMA (Ecstasy, XTC, Essence), hallucinogens (STP, PMA, EVE) and analogs of PCP.
Slide 30
Handout 22